Liposuction

Liposuction, also known as lipoplasty ("fat modeling"), liposculpture suction lipectomy ("suction-assisted fat removal") or simply lipo is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs and buttocks, to the neck, backs of the arms and elsewhere.

Candidacy

Not everyone is a good candidate for liposuction. It is not a good alternative to dieting or exercising. To be a good candidate, one must usually be over 18 and in good general health, have an ongoing diet and exercise regime, and have fatty pockets of tissue available in certain body areas. Significant disease limiting risk (e.g. Diabetes, any infection, heart or circulation problems) weigh against the eligibility of a person for the procedure. In older people, the skin is usually less elastic, limiting the ability of the skin to readily tighten around the new shape. Liposuction of the abdominal fat should not be combined with simultaneous tummy tuck procedures due to higher risk of complications and mortality.

Techniques

In general, fat is removed via a cannula (a hollow tube) and aspirator (a suction device). Liposuction techniques can be categorized by the amount of fluid injection and by the mechanism in which the cannula works.

Dry liposuction

Suction-assisted liposuction (SAL)

Suction-assisted liposuction is the standard method of liposuction. In this approach, a small cannula (like a straw) is inserted through a small incision. It is attached to a vacuum device. The surgeon pushes and pulls it in a forwards and backwards motion, carefully through the fat layer, breaking up the fat cells and drawing them out of the body by suction.

Ultrasound-assisted liposuction (UAL)

In ultrasound-assisted or ultrasonic liposuction, a specialized cannula is used which transmits ultrasound vibrations within the body. This vibration bursts the walls of the fat cells, emulsifying the fat (i.e. liquefying it) and making it easier to suction out.

Power-assisted liposuction (PAL)

PAL uses a specialized cannula with mechanized movement, so that the surgeon does not need to make as many manual movements. Otherwise it is similar to traditional SAL.

Twin-cannula (assisted) liposuction (TCAL or TCL)

Twin cannula (assisted) liposuction uses a tube-within-a-tube specialized cannula pair, so that the cannula which aspirates fat, the mechanically reciprocated inner cannula, does not impact the patient's tissue or the surgeon's joints with each and every forward stroke. The aspirating inner cannula reciprocates within the slotted outer cannula to simulate a surgeon's stroke of up to 5 cm (2 in) rather than merely vibrating 1–2 mm (1/4 in) as other power assisted devices, removing most of the labor from the procedure.

External ultrasound-assisted liposuction (XUAL or EUAL)

XUAL is a type of UAL where the ultrasonic energy is applied from outside the body, through the skin, making the specialized cannula of the UAL procedure unnecessary.

Water-assisted liposuction (WAL)

WAL uses a thin fan-shaped water beam, which loosens the structure of the fat tissue, so that it can be removed by a special cannula. During the liposuction the water is continually added and almost immediately aspirated via the same cannula. WAL requires less infiltration solution and produces less immediate edema from the tumescent fluid.

The Procedure for Liposuction Surgery

Liposuction or fat removal surgery is performed either under general anaesthetic or under local anaesthetic with sedation, and is often treated as a day case, meaning you will not have to stay in hospital overnight. The procedure usually takes between one and two hours to complete depending on the area being treated and how much fat is being removed. Your surgeon will make a small incision in the area being treated before inserting a thin plastic tube called a cannula. The other end of this cannula is attached to a powerful vacuum device which removes the fat quickly and efficiently.

Risks of Liposuction

Fortunately, significant complications from liposuction surgery are infrequent. Liposuction surgery is one of the two most common procedures performed by plastic surgeons. Most often this surgery is performed without experiencing any major problem.
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon's office. The risks in most surgeries are similar. Some of the potential complications that may be discussed with you include hematoma (an accumulation of blood under the skin that may require removal), infection, changes in sensation, scarring, allergic reactions, damage to underlying structures, need for revisions, unsatisfactory results possibly necessitating additional procedures and medical risks. Other risks more specific to liposuction may include indentations and irregularities.
You can help minimize certain risks by following the advice and instructions of your plastic surgeon, both before and after your liposuction surgery.